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When's the best time to get pregnant? Use our interactive ovulation calculator to work out when you're most fertile and most likely to conceive.

Original poster

Short luteal phase - referred to fertility clinic - what next?

86 replies

kennetrose · 01/02/2021 10:03

Hi. I've been TTC with my fiancé for a few months. I track my cycles with OPKs and a TempDrop so I'm confidant I'm pinpointing ovulation each cycle. My LP is consistently 8 days. I was not on HBC - I had a copper IUD.

Because of my consistently short LP, I went to see my GP who ordered CD3 bloods (all normal) and CD21 progesterone. The first time I was 7DPO and the result was 4.1 nmol/L. Second time I was 8DPO and the result was 4.6 nmol/L (I think 12-49 nmol/L is what they're looking for). Because of this, my GP referred me to the fertility clinic, pending my fiancé's sperm analysis (we're just waiting for the results of that - he did it last week).

I've been taking vitamin B6 and vitamin C supplements since the beginning of October but they don't seem to have had any effect on lengthening my LP so far.

I've read research that suggests short LPs with no other issue can delay the time to a positive test but there isn't a significant difference in birth rates. I understand the reasons behind this now. I had a private gynaecologist remove my IUD and he said not to worry about short LP.

However what I don't understand is whether or not I have an issue. My GP said my CD21 results suggest I'm not ovulating, but that contradicts my data. What I think it shows is that my body isn't producing much progesterone, but does that mean the test is missing my peak or I'm just not producing much after ovulation? And will that prevent pregnancy or not?

So I have a lot of questions and no way of answering them until I finally get to the fertility clinic, and who knows how long that will be. Spending so much time on Reddit I see a lot of Americans get treated straight away for anything but I know UK doctors don't like overtreating and I don't know what the NHS approach normally is.

My questions are

  • has anyone been in a similar situation to me, and what was the outcome?
  • what normally happens when you get to the fertility clinic?
  • do things like Clomid and letrozole get prescribed much in the UK to treat what might be 'weak ovulation'?
OP posts:
LondonladyTTC · 24/03/2021 10:20

Congratulations @Rose2108 ! What an encouraging story  wishing you a happy and healthy pregnancy.

@kennetrose we plan to give it three cycles with trigger injection and progesterone and he said he is very confident it will work (but feeling a little more disheartened after it didn't work last cycle). Not on clomid at the moment, he said he wanted to refrain from stimulating my ovaries until we see if this works as think it is a luteal phase issue (progesterone related) rather than something that's going on at the start of my cycle which happens to impact my luteal phase. Being honest, I am not sure what the next steps will be- whether it will be clomid or straight to iui but will keep you updated on my progress in case it helps you.

I had two maturing eggs again at my scan on CD10, one 16mm and one 14mm, oddly both in the left ovary (not sure why I expected if two, one would be in each ovary) so hoping they have both fully matured and released in case having two ups my chances for a bfp this month (no idea if it does!)

Original poster
kennetrose · 24/03/2021 09:19

thanks @LondonladyTTC and sorry it didn't work the first time - fingers crossed next time. Did the doctor say how many cycles he'd give it with progesterone? Are you doing Clomid or something now too, with the trigger shot? They said I'd ovulate in three days based on the size - it was 13mm, you ovulate when it's about 18mm, and it grows just over a mm a day. But every follicle is different and they grow at different rates, otherwise we'd all have identical clockwork cycles.

It's weird how the bar for ovulation varies depending on who you ask. The nurse told me 20 but I've seen 30 written down elsewhere. I know it's easy to miss the peak so it makes sense there isn't a set number, but 20 and 30 seems like a big difference.

@Rose2108 thanks - it does give me some hope! NHS just don't care that can track our cycles accurately and assume we're wrong even though I know I'm right!

Short LPs....I get why doctors won't treat it outright, unless you have failed to conceive, because people do get pregnant with them (Rose2108 for example!). We haven't reached the year point but because my cycles are so short we have a lot of them under our belt! Given we have so many unsuccessful cycles, even though short LP isn't always a problem, in me I think it is a problem. Just need someone to take me seriously. I'm just so mad at my body and the universe for not being pregnant yet.

OP posts:
Rose2108 · 24/03/2021 07:47

@kennetrose I can feel your frustration! I just don't think the NHS recognise this as an issue do they, my GP actually said to me that the day you ovulate is irrelevant, as long as you ovulate (?!). It's great news you're ovulating but just seems so unfair they won't give you more support. Sorry you're going through this.

Good luck @LondonladyTTC

In Feb, I ovulated on CD19 and was due AF on CD 27, so just 8 days. Amazingly at 7dpo, I felt a twinge and had some spotting, assuming it was early AF which is quite normal for me, but unbelievable it was implantation and I got my bfp a few days later. We had been TTC for nine months and my luteal phase varied from 5 days - 12 days. I suppose I just got lucky that it happened within just a week. I just wanted to share this to give you hope! I'm 8 weeks now, so still have a few weeks to go before I can get confirmation everything is okay but it's my first BFP. I was taking Agnus Castus to regulate my cycle, vitamin C and a Vitamin B complex.

LondonladyTTC · 23/03/2021 22:42

@kennetrose sorry to hear about your experience, sounds so frustrating!!! Also, that progesterone result seems quite low from what I understand (but I am obviously not a medical professional!) mine was 27 at 7dpo and I was told it was a slightly low so got given the cyclogest. I was told if it was under 5 it would indicate no ovulation, but over 30 would be normal. I am also not sure how they could have accurately pinpointed when ovulation would be without controlling it with a trigger shot or something...
I suspect that you will have your progesterone retested as part of your fertility plus treatment (I have had mind checked twice now, before and after starting the cyclogest). It really is such a weight off having the defect recognised and getting treatment so I am sure you won't be disappointed.
Sadly didn't work for me last month but today is ovulation day after a trigger shot on Sunday, so will be onto the next two week wait- it feels never ending! Cycle 13 for me now!

Original poster
kennetrose · 23/03/2021 16:15

I need to vent. I have now gone through the NHS assessment. They did an ultrasound, saw a follicle, and predicted I'd ovulate on CD14 and should come in for a progesterone test at 5dpo. Well I didn't ovulate until CD17, so went for my progesterone test later. Called for the result yesterday and was told it was good news, I ovulated! My result was 19.8 nmol/L and although they look for 20 nmol/L it was high enough.

I got my period yesterday, after the call, at 8DPO. My LP was SEVEN days! That's short even for me. The nurse just didn't care - she said it was 'potentially' enough time for an embryo to implant. Potentially isn't good enough!! But that's it - the NHS won't do anything now. They want me to come in for a HyFoSy so I think at that point I'll push the point again and try to get a consultation with the doctor, but I'm not hopeful.

So glad I have my appointment at Fertility Plus a month today but I'm sick of medical staff not believing me. I wish I was lying about my 8 day LP. The nurse yesterday even tried to argue with me 'well the scan said you'd ovulate on day 14, so that was 11 days ago, that's plenty of time'. Did she not hear me say I didn't ovulate until day 17? It doesn't matter what the scan says when OPKs, CM and temping all pinpoint ovulation to day 17.

Anyway rant over. 23 April cannot come soon enough.

OP posts:
paintfairy · 10/03/2021 22:43

@kennetrose who knows. But one of the months they did the progesterone test i spotted every day for the whole 2 weeks! So it was happening before the test and yet the test came back at 48? Which did shock me. I did ask though and she said the progesterone test only shows you ovulated. It doesn't really tell them much more than that.

Original poster
kennetrose · 10/03/2021 15:06

none of this makes any sense...unfortunately. Things that look like problems are sometimes not problems at all, other times there are problems with no causes.

Progesterone is released in pulses which is why testing it is tricky. Maybe it rises and drops quickly in you @paintfairy, causing the spotting?

OP posts:
paintfairy · 10/03/2021 14:49

@kennetrose I did ask if something else can be causing the spotting. I've already had all the tests now (normal) and I've got a HSG next cycle. She seemed to think it would be progesterone and I suppose the proof relies on whether it works. If it does work then it must be that, but it still makes no sense. I often spot on and off through my LP and so far I've had none. But really tomorrow onwards will be the real test.....

Original poster
kennetrose · 10/03/2021 14:25

I don't get spotting usually. For me it's more like a tap just turns on at 8DPO exactly. Have you asked your fertility clinic that question @paintfairy? If your progesterone is normal I'd say your ovulation is fine and it's something else happening.

I had my fertility consult last week, had a scan this week, and am having another progesterone test at 5DPO next week. Super interested to see what my progesterone is doing now. If it doesn't indicate ovulation I'll have a consultation with the doctor, if it does then they'll do a tubal check and I guess I'll be on my way for who knows how long. A little nervous - it's not that I want a problem, but I am convinced there is and if my progesterone test is normal at 5DPO then I'll be on my own again.

OP posts:
paintfairy · 10/03/2021 13:17

I've found this post quite interesting. My LP isn't short but I've spotted through it every single month since I came off the pill in 2018.
My day 21 tests (had 2 now) were 45 and 48 - so not low. The fertility clinic have given me cyclogest to trial. I have mixed feelings as to whether this will work, because of the thought that a poor ovulation is the cause of a LP defect. But being my day 21 results aren't low- does that indicate a poor ovulation or literally just something strange happening in the LP? The first day 21 test i had i was spotting from several days before the blood test even was done (mine really does vary by month) yet the result wasn't low.
None of it makes any sense to me!

Rose2108 · 22/02/2021 14:26

That is a reasonable cost @LondonladyTTC when I think how much I have probably spent on OPK's, supplements, etc! I enquired about a private clinic locally and the first session is £190, they recommend you get the basic day 3 / 21 bloods and the SA done in advance with NHS if you can, to save doing it through them, but I know that isn't an option for everyone. That also all makes so much sense and sounds really positive, hopefully just a matter of time for you :)

@Kitte321 Pleased to hear it worked for your LP, steps in the right direction hopefully. Hopefully this is what I can start taking to lengthen mine!

@kennetrose Glad the SA results were as expected. Agree re GP's - I understand they cannot be experts in all fields but it is really upsetting when they make you feel stupid and ask you questions like "What would you like me to do for you" - I felt like crying! I said I want you to help me.... And he just sent me for the bloods.

Do you all get pre-AF spotting too?

unCliche · 22/02/2021 13:28

@LondonladyTTC ah just realised you went private. I paid £550 for AMH, scans, SA and consultation. But if you got medication too, yours was probably better value for money.

LondonladyTTC · 22/02/2021 13:16

@kennetrose The follicle count scan, 7 dpo blood test (getting next week), and medications came to £320 which is actually less than I expected to be honest.

unCliche · 22/02/2021 13:10

@LondonladyTTC that sounds like great news. At least you can move forward in your TTC journey with confidence that you will get pregnant! I was going to ask the same question as @kennetrose about how much it all costs via the NHS. I'm private so I expect it to be more 😱

Original poster
kennetrose · 22/02/2021 12:58

@LondonladyTTC another way we're similar - my AMH is 13.8. Almost identical! How much were all the medications if you don't mind me asking? Just wondering what I might be getting in for.

OP posts:
LondonladyTTC · 22/02/2021 12:55

@kennetrose congrats on booking your appointment! Very exciting.

@Rose2108 , sorry your GP was a useless as mine 
Yes, I had my test results back. I thought AMh was low at 13.7 but he said it was actually perfectly fine. Progesterone was on the low side but did indicate ovulation. I had my second appointment on Friday and got my luteal phase defect confirmed after a scan of my ovaries (follicles were no way near fully developed on cycle day 10 and I only have a 24 day cycle which led to the conclusion that my luteal phase would be short). My suspicious were confirmed that any fertilised egg would have not had time to implant due to the defect. This month I am trying an ovitrelle injection (took last night) to stimulate ovulation and then will be taking progesterone suppositories for 14 days. He was very positive as ovaries looked healthy and I had a good egg supply and apparently had two maturing eggs, one in each ovary. Took all the medication home with me on the day and left feeling very positive. I feel a huge weight has been lifted from my shoulders, I knew something wasn't right. He said he is very confident I will be pregnant within a few months, so way more relaxed now and would recommend these private investigations to anyone who can afford it.

thislittlebird · 22/02/2021 11:53

Hi @kennetrose. I have nothing of much use to add but thought I might join/watch the thread as I’m in a similar position. My last progesterone result was 10 so it seems unclear if I’m ovulating (although everything else suggests I am) but my luteal phase is a normal length. I’ve been referred based on this too, waiting for the appointment and just taking supplements and doing acupuncture in the meantime.

A private doctor did suggest cycle monitoring to me but I’ve already had my follicle count and lining scan and my AMH done so I’m not sure what additional monitoring it (at some cost) will show.

Original poster
kennetrose · 22/02/2021 11:38

@Kitte321 sorry about the BFN. Guess people with short LPs never truly know what the murder zone is, which is a small blessing. I hope your period comes soon and you have better luck next cycle.

OP posts:
Original poster
kennetrose · 22/02/2021 11:36

hey @Rose2108 sorry your GP was useless! GPs really don't know much about TTC. They parrot off just relax, have sex EOD etc and aren't interested when you educate yourself about your cycle because it contradicts what they are told to say. Not to slag off all GPs, they are a wonderful resource, but with TTC you really have to advocate for yourself! Especially when you're speaking to male GPs, I've found. I think GPs are just the gatekeepers to specialists. You just have to deal with them until the refer you onwards. Persistence helps. We got our SA results back at last - apparently normal which is good but haven't seen the breakdown.

@LondonladyTTC I booked my appointment with Dr Gudi this morning! It's not until 23 April which I expected from what you said. Did you have an ultrasound or blood tests done at your first appointment?

OP posts:
Kitte321 · 22/02/2021 11:15

Hello @Rose2108 yes I did, so I guess the cycle was kind of a success - sadly I didn’t get a BFP tho. So I did progesterone 2 dpo. I’m currently on 14dpo with no sign of AF but a BFN this am so I’ll stop taking the pessaries and wait for AF to arrive.
It’s an incredibly long slog with little certainty 😔

Rose2108 · 22/02/2021 11:05

Hi @kennetrose, hope you are doing well, did you get your SA results back? I think we are heading to these tests etc now, 13 months in with not a single BFP (I'm 31 and seem to ovulate monthly with OPK's / BBT). I've just done my day 21 bloods last week.

My cycle issues are:

  • 26 - 30 day cycle
  • Ovulation is late, between CD 17 - CD 23
  • LP has been anything from 7 days to 10 days
  • Pre-AF spotting for 1 - 3 days, usually with nausea and cramping
  • No temp drop when starting AF, temps remain high for a few days
  • Light AF usually with maybe only one heavy day.

Sadly when I spoke to the GP he was utterly useless, didn't listen to me, had me on loud speaker and seemed busy doing some paperwork. He asked me what I wanted them to do about my short LP basically. I am at my wits end with this!!

@Kitte321 - Did you get your longer luteal phase?
@Debs726 - Your private appt sounded great, please let us know how you get on.
@LondonladyTTC - Did you get your test results back?

There is just so much information out there it is so overwhelming. I don't think my cycle is a total disaster and a least I ovulate monthly, but just feel a bit bemused by this short LP. One month I ovulated on CD 17 so was delighted by that, but I started spotting on CD24. There definitely seems to be a gang of ladies who have this issue!

unCliche · 16/02/2021 15:22

I'm in the same boat. I did suspect I had issues with my hormones in my luteal phase as my BBT took 'slow rise' to a new extreme and LP is a little on the short side. I decided to take a at home progesterone test at 6DPO and my results came back low: 27nmol/L where > 30nmol/L indicates ovulation.

Around the end of cycle 3, I too went to see a fertility specialist and got scans and bloods done. AMH was at 40.5 (I'm 28) so physically I'm fine but I just knew something wasn't right with my hormones.

So, even though I do ovulate every month, I just don't think my ovulations are "strong" enough, so I'm speaking to my fertility consultant soon to see what he suggests. Plus I'll need to consider DHs SA in all of this because although he apparently has good quality sperm his count per ml is low. We're currently on cycle 6 and taking a little break because quite frankly, I'm a bit fed up 😅

Hopefully your DPs SA results come back fine so you have a lot less to deal with 🤞

Original poster
kennetrose · 16/02/2021 15:01

@Juno231 oh that's interesting. I'm struggling to find my CCG's full guidance on fertility. I've only found details about IVF. Any pointers on what to search for?

We are hopefully getting our SA results tomorrow and having an appointment with our GP who should finally put our referral to the fertility clinic through. No idea what wait times are so want to get a consultation with a specialist to at least have a plan of action, even if we don't act on it yet. Just feel in limbo now and want to get moving!!

OP posts:
Juno231 · 16/02/2021 14:28

@kennetrose just wanted to jump in and say to definitely double check your local CCG policy on assisted conception as some areas definitely do medically assisted IUIs. Another lady on MN I chat to has been told to go down that route and that the NHS will fund 3 of them. In my local CCG they fund up to 12 IUIs but weirdly all unassisted!

ellenpartridge · 16/02/2021 13:47

I was prescribed progesterone (cyclogest suppositories) by a private clinic (south west) and got pregnant that cycle. This was a few months after a miscarriage. I believe the progesterone made a huge difference. I was tracking BBT and the chart looked much much better with the progesterone. Had previously had a borderline short LP of around 10 days but quite low progesterone levels in the LP.

GP had no idea or interest in potential luteal phase issues but specialists were great.

I'd definitely encourage you to pursue it with a specialist. Best of luck.

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